子宫背带式缝合术治疗剖宫产术中难治性产后出血的临床研究(1)
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[摘要] 目的：探讨子宫背带式缝合术即B-Lynch子宫缝合术在剖宫产术中难治性产后出血的临床应用。方法：观察组50例剖宫产术时因子宫收缩乏力引起的产后出血住院患者采用常规止血方法无效时，应用子宫背带式缝合术治疗。随机选择25例同样病例作为对照组，采用常规止血方法治疗无效，用传统方法行次全子宫切除术。在手术时间、产后出血量及产褥病率等方面对比两组术式的临床疗效。结果：观察组病例治疗后临床效果显著，其手术时间、产后出血量及产褥病率与对照组比较，差异均有高度统计学意义(均P<0.01)。结论：子宫背带式缝合术是一种操作简单、耗时短、损伤小、恢复快的方法，既能治疗剖宫产术中因子宫收缩不良所致的产后出血，又可使产妇免于切除子宫的危险，并能保留生育功能，是治疗剖宫产术中宫缩乏力引起的难治性产后出血行之有效的止血方法。
[关键词] 子宫背带式缝合术；剖宫产术；宫缩乏力；产后出血
[中图分类号] R719.8[文献标识码]A [文章编号]1673-7210(2010)10(c)-042-02
Clinical research on strap-uterine suture for intractable postpartum hemorrhage in cesarean section
XING Rongli, HUANG Yanping
(Nanzhuang Hospital of Chancheng District in Foshan City, Guangdong Province, Foshan 526081, China)
[Abstract] Objective: To evaluate clinical application of strap-uterine suture (B-Lynch uterine suture) for intractable postpartum hemorrhage in cesarean section. Methods: The observation group of 50 hospitalized patients with postpartum hemorrhage uterine inertia in cesarean section were used strap-uterine suture when conventional method was invalid. 25 patients like the observation group as control group, they used subtotal hysterectomy when conventional method was invalid. The clinical efficacy of two surgical procedures on the operation time, post-partum hemorrhage and puerperal morbidity were compared. Results: The efficacy was significant in observation group after treatment, there were significant differences on the operation time, postpartum hemorrhage and puerperal morbidity compared with those of the control group (all P<0.01). Conclusion: Strap-uterine suture is a method of simple, time-consuming short, little damage, quick recovery. It can treat postpartum hemorrhage uterine inertia in cesarean section, also enable mothers away from the risk of hysterectomy, and preserve the reproductive function. It′s an effective method to treat intractable postpartum hemorrhage uterine inertia in cesarean section.
[Key words] Strap-uterine suture; Cesarean section; Uterine inertia; Postpartum hemorrhage
产后出血是指胎儿娩出后24 h内阴道流血量超过500 ml，是产科较严重的并发症，居我国产妇死亡原因首位，其发生率占分娩总数的2%～3%[1]，而剖宫产术产后出血率高达19.8%[2]，一旦发生，预后严重，是孕产妇死亡的首要原因。对经各种常用保守治疗无效者，按传统方法行次全子宫切除术 ......
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